Provider Demographics
NPI:1356510168
Name:JONES, MATHEW LYMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:LYMAN
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3719
Mailing Address - Country:US
Mailing Address - Phone:580-357-4946
Mailing Address - Fax:580-357-1019
Practice Address - Street 1:814 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3719
Practice Address - Country:US
Practice Address - Phone:580-357-4946
Practice Address - Fax:580-357-1019
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics